Ariana Rodrigues da Silva Carvalho

Cross-cultural adaptation and psychometric properties of the Brazilian–Portuguese version of the Duke Anticoagulation Satisfaction Scale

AIM The aim of this study was to evaluate the internal reliability and validity of the Brazilian-Portuguese version of Duke Anticoagulation Satisfaction Scale (DASS) among cardiovascular patients. BACKGROUND Oral anticoagulation is widely used to prevent and treat thromboembolic events in several conditions, especially in cardiovascular diseases; however, this therapy can induce dissatisfaction and reduce the quality of life. DESIGN Methodological and cross-sectional research design. METHODS The cultural adaptation of the DASS included the translation and back-translation, discussions with healthcare professionals and patients to ensure conceptual equivalence, semantic evaluation and instrument pretest. The Brazilian-Portuguese version of the DASS was tested among subjects followed in a university hospital anticoagulation outpatient clinic. The psychometric properties were assessed by construct validity (convergent, known groups and dimensionality) and internal consistency/reliability (Cronbachs alpha). RESULTS A total of 180 subjects under oral anticoagulation formed the baseline validation population. DASS total score and SF-36 domain correlations were moderate for General health (r=-0.47, p<0.01), Vitality (r=-0.44, p<0.01) and Mental health (r=-0.42, p<0.01) (convergent). Age and length on oral anticoagulation therapy (in years) were weakly correlated with total DASS score and most of the subscales, except Limitation (r=-0.375, p<0.01) (Known groups). The Cronbachs alpha coefficient was 0.79 for the total scale, and it ranged from 0.76 (hassles and burdens)-0.46 (psychological impact) among the domains, confirming the internal consistency reliability. CONCLUSIONS The Brazilian-Portuguese version of the DASS has shown levels of reliability and validity comparable with the original English version. RELEVANCE TO CLINICAL PRACTICE Healthcare practitioners and researchers need internationally validated measurement tools to compare outcomes of interventions in clinical management and research tools in oral anticoagulation therapy.

Avaliação do apoio social e da auto-estima por indivíduos coronariopatas, segundo o sexo

The purpose of this descriptive study was to evaluate the social support and self-esteem of coronary disease patients hospitalized for the clinical treatment of this disease. The sample consisted of 80 patients, 49 men, 52 married, and with an average age of 52 years. Interviews took place from August 2005 to July 2006. The collected data were analyzed using descriptive analysis, and the measured social support and self-esteem were compared by the descriptive statistics, and the social support and self-esteem measures were compared using the Mann-Whitney test, according to patient gender. Internal consistency was verified, achieving values that indicate good internal consistency for both scales. The results showed high social support and self-esteem values in the studied group. No statistically significant differences were found between these values, according to patient gender. These variables have been pointed out as aspects that favor the rehabilitation process of heart disease patients after hospital discharge.The purpose of this descriptive study was to evaluate the social support and self-esteem of coronary disease patients hospitalized for the clinical treatment of this disease. The sample consisted of 80 patients, 49 men, 52 married, and with an average age of 52 years. Interviews took place from August 2005 to July 2006. The collected data were analyzed using descriptive analysis, and the measured social support and self-esteem were compared by the descriptive statistics, and the social support and self-esteem measures were compared using the Mann-Whitney test, according to patient gender. Internal consistency was verified, achieving values that indicate good internal consistency for both scales. The results showed high social support and self-esteem values in the studied group. No statistically significant differences were found between these values, according to patient gender. These variables have been pointed out as aspects that favor the rehabilitation process of heart disease patients after hospital discharge.

Health related quality of life of patients undergoing oral anticoagulation therapy.

Se trata de un estudio descriptivo, de tipo corte transversal, que tuvo como objetivo analizar la calidad de vida relacionada a la salud (CVRS) y su relacion con sexo, edad, tiempo e indicacion de uso de anticoagulantes orales. Fueron entrevistados 178 pacientes y la CVRS fue evaluada por los ocho dominios del SF-36. Fue utilizada estadistica descriptiva, las pruebas: t Student, ANOVA y Tukey, para comparacion de los promedios entre los grupos. La indicacion para el uso fue predominantemente la protesis cardiaca metalica (50%) y la warfarina el anticoagulante mas prescrito (83,3%). Los promedios de los dominios del SF-36 variaron de 82 (Aspectos sociales) a 54,8 (Aspectos fisicos). Mujeres, ancianos, y pacientes con diagnostico de fibrilacion atrial y con menos de un ano de uso del medicamento, presentaron peor evaluacion de la CVRS. Los resultados obtenidos pueden orientar acciones de enfermeria, en la medida en que indican posibles asociaciones entre la CVRS y las variables sociodemograficas y clinicas de los pacientes.This is a descriptive cross-sectional study, which aimed to analyze the health related quality of life (HRQoL) and its relationship with gender, age, duration and indication for the use of oral anticoagulants. A total of 178 patients were interviewed and the HRQoL was assessed through eight domains of the SF-36. The descriptive statistics used were, the Students t, ANOVA and Tukeys tests for the comparison of the means between the groups. The indication for use was predominantly the metallic prosthetic heart valve (50%) with warfarin the most widely prescribed anticoagulant (83.3%). The means of the domains of the SF-36 ranged from 82 (Social aspects) to 54.8 (Physical aspects). Women, elderly, patients diagnosed with atrial fibrillation and with less than one year of medication use, presented a worse HRQoL evaluation. The results obtained can guide nursing actions, in that they indicate possible associations between the HRQoL and the sociodemographic and clinical variables of the patients.

Gender-specific evaluation of coronary disease patients' self-esteem and social support

The purpose of this descriptive study was to evaluate the social support and self-esteem of coronary disease patients hospitalized for the clinical treatment of this disease. The sample consisted of 80 patients, 49 men, 52 married, and with an average age of 52 years. Interviews took place from August 2005 to July 2006. The collected data were analyzed using descriptive analysis, and the measured social support and self-esteem were compared by the descriptive statistics, and the social support and self-esteem measures were compared using the Mann-Whitney test, according to patient gender. Internal consistency was verified, achieving values that indicate good internal consistency for both scales. The results showed high social support and self-esteem values in the studied group. No statistically significant differences were found between these values, according to patient gender. These variables have been pointed out as aspects that favor the rehabilitation process of heart disease patients after hospital discharge.The purpose of this descriptive study was to evaluate the social support and self-esteem of coronary disease patients hospitalized for the clinical treatment of this disease. The sample consisted of 80 patients, 49 men, 52 married, and with an average age of 52 years. Interviews took place from August 2005 to July 2006. The collected data were analyzed using descriptive analysis, and the measured social support and self-esteem were compared by the descriptive statistics, and the social support and self-esteem measures were compared using the Mann-Whitney test, according to patient gender. Internal consistency was verified, achieving values that indicate good internal consistency for both scales. The results showed high social support and self-esteem values in the studied group. No statistically significant differences were found between these values, according to patient gender. These variables have been pointed out as aspects that favor the rehabilitation process of heart disease patients after hospital discharge.

Perfil sócio demográfico e clínico de pacientes em uso de anticoagulantes orais

Este estudo teve como objetivo investigar o perfil socio-demografico, clinico e laboratorial de individuos em seguimento ambulatorial devido ao uso de anticoagulantes orais. O estudo foi descritivo, transversal, realizado no ambulatorio de anticoagulacao oral de um hospital terciario do interior do estado de Sao Paulo. Os dados foram coletados por entrevistas e consultas aos prontuarios dos pacientes. Participaram 180 sujeitos, a maioria do sexo feminino (65,6%), com idade media de 55 anos, em uso de varfarina (83,3%) ha mais de 6,9 anos, devido a presenca de protese cardiaca metalica (50%). Os resultados obtidos fornecem subsidios para os enfermeiros planejarem a assistencia aos usuarios de anticoagulacao oral com vistas a diminuicao de possiveis complicacoes relacionadas a terapia e ao aumento da adesao ao tratamento.

Qualidade de vida relacionada à saúde de pacientes em uso de anticoagulação oral

Se trata de un estudio descriptivo, de tipo corte transversal, que tuvo como objetivo analizar la calidad de vida relacionada a la salud (CVRS) y su relacion con sexo, edad, tiempo e indicacion de uso de anticoagulantes orales. Fueron entrevistados 178 pacientes y la CVRS fue evaluada por los ocho dominios del SF-36. Fue utilizada estadistica descriptiva, las pruebas: t Student, ANOVA y Tukey, para comparacion de los promedios entre los grupos. La indicacion para el uso fue predominantemente la protesis cardiaca metalica (50%) y la warfarina el anticoagulante mas prescrito (83,3%). Los promedios de los dominios del SF-36 variaron de 82 (Aspectos sociales) a 54,8 (Aspectos fisicos). Mujeres, ancianos, y pacientes con diagnostico de fibrilacion atrial y con menos de un ano de uso del medicamento, presentaron peor evaluacion de la CVRS. Los resultados obtenidos pueden orientar acciones de enfermeria, en la medida en que indican posibles asociaciones entre la CVRS y las variables sociodemograficas y clinicas de los pacientes.This is a descriptive cross-sectional study, which aimed to analyze the health related quality of life (HRQoL) and its relationship with gender, age, duration and indication for the use of oral anticoagulants. A total of 178 patients were interviewed and the HRQoL was assessed through eight domains of the SF-36. The descriptive statistics used were, the Students t, ANOVA and Tukeys tests for the comparison of the means between the groups. The indication for use was predominantly the metallic prosthetic heart valve (50%) with warfarin the most widely prescribed anticoagulant (83.3%). The means of the domains of the SF-36 ranged from 82 (Social aspects) to 54.8 (Physical aspects). Women, elderly, patients diagnosed with atrial fibrillation and with less than one year of medication use, presented a worse HRQoL evaluation. The results obtained can guide nursing actions, in that they indicate possible associations between the HRQoL and the sociodemographic and clinical variables of the patients.

Calidad de vida relacionada a la salud de pacientes que usan anticoagulación oral

Se trata de un estudio descriptivo, de tipo corte transversal, que tuvo como objetivo analizar la calidad de vida relacionada a la salud (CVRS) y su relacion con sexo, edad, tiempo e indicacion de uso de anticoagulantes orales. Fueron entrevistados 178 pacientes y la CVRS fue evaluada por los ocho dominios del SF-36. Fue utilizada estadistica descriptiva, las pruebas: t Student, ANOVA y Tukey, para comparacion de los promedios entre los grupos. La indicacion para el uso fue predominantemente la protesis cardiaca metalica (50%) y la warfarina el anticoagulante mas prescrito (83,3%). Los promedios de los dominios del SF-36 variaron de 82 (Aspectos sociales) a 54,8 (Aspectos fisicos). Mujeres, ancianos, y pacientes con diagnostico de fibrilacion atrial y con menos de un ano de uso del medicamento, presentaron peor evaluacion de la CVRS. Los resultados obtenidos pueden orientar acciones de enfermeria, en la medida en que indican posibles asociaciones entre la CVRS y las variables sociodemograficas y clinicas de los pacientes.This is a descriptive cross-sectional study, which aimed to analyze the health related quality of life (HRQoL) and its relationship with gender, age, duration and indication for the use of oral anticoagulants. A total of 178 patients were interviewed and the HRQoL was assessed through eight domains of the SF-36. The descriptive statistics used were, the Students t, ANOVA and Tukeys tests for the comparison of the means between the groups. The indication for use was predominantly the metallic prosthetic heart valve (50%) with warfarin the most widely prescribed anticoagulant (83.3%). The means of the domains of the SF-36 ranged from 82 (Social aspects) to 54.8 (Physical aspects). Women, elderly, patients diagnosed with atrial fibrillation and with less than one year of medication use, presented a worse HRQoL evaluation. The results obtained can guide nursing actions, in that they indicate possible associations between the HRQoL and the sociodemographic and clinical variables of the patients.

Validação da escala Índice de Estresse Parental para o português do Brasil

Objective : To present the cultural adaptation and validation of the Parenting Stress Index for Brazilian Portuguese. Methods : Methodological research. For the validation, the scale was applied to 53 mothers of premature infants at the outpatient monitoring clinic of a public teaching hospital in Parana between November 2013 and July 2014. For the data analysis, descriptive and inferential statistics were used. Results : The reliability was satisfactory for the complete scale (α=0.91) and the domains: Child domain (α=0.87) and parents’ domain (α=0.88). The principal components explained 64.57% of total item variation, being 45.16% from the child’s domain and 17.80% from the parents’ domain. Conclusion : The scale was appropriate to assess maternal stress after hospital discharge, endorsing its use in the Brazilian context in new studies to enhance its reliability and validity.

Anticoagulação oral: impacto da terapia na qualidade de vida relacionada à saúde ao longo de seis meses

OBJETIVO: estudar as mudancas na qualidade de vida relacionada a saude do inicio da anticoagulacao oral ao final de seis meses dessa terapia, e estudar as associacoes das caracteristicas sociodemograficas e clinicas com as medidas de qualidade de vida e estado de saude geral seis meses apos o inicio do tratamento, em individuos com diversas indicacoes clinicas para anticoagulacao oral. METODO: estudo prospectivo realizado em um municipio do Parana, Brasil, avaliando 78 pacientes. Foram utilizados os instrumentos Duke Anticoagulation Satisfaction Scale e Medical Outcomes Survey Short Form SF-36. RESULTADOS: a idade media foi 57 anos (D.P.= 16) e 54% eram mulheres. Comparado com o inicio da terapia, houve melhora estatisticamente significante na qualidade de vida relacionada a saude aos seis meses de seguimento. Os modelos de regressao linear explicaram 32% e 30%, respectivamente, da variância do Duke Anticoagulation Satisfaction Scale e do estado geral de saude. Houve melhora em todos os componentes do SF-36, exceto Saude Mental. CONCLUSAO: O uso do anticoagulante oral foi associado a melhora da qualidade de vida relacionada a saude nos seis meses de acompanhamento. Por ser longitudinal, esse estudo tem menos limitacoes que os estudos transversais publicados na area da Enfermagem brasileira ate o momento.OBJECTIVE to study the changes in health-related quality of life from beginning of anticoagulation therapy to six-month follow-up, and to study associations of sociodemographic and clinical characteristics with measures of quality of life and general health status at six-month follow-up, in individuals using oral anticoagulation due to various medical indications for the therapy. METHOD prospective study performed at a city in the state of Paraná, Brazil, composed of 78 patients. Measures included the Duke Anticoagulation Satisfaction Scale and the Medical Outcomes Survey Short Form SF-36. RESULTS mean age was 57 years (S.D.= 16) and 54% were women. Compared to the beginning of therapy, there was a statistically significant improvement in health-related quality of life at six-month follow-up. Linear regression analyses explained 32% and 30%, respectively, of the variance of the Duke Anticoagulation Satisfaction Scale and of the general health status. There was improvement in all components of the SF-36, except Mental Health. CONCLUSION The use of oral anticoagulation therapy was associated with improvement in health-related quality of life in the first six months of therapy. This study is longitudinal and therefore, has fewer limitations than cross-sectional studies published to date in the Nursing literature in Brazil.

Oral Anticoagulation: the impact of the therapy in health-related quality of life at six-month follow-up

OBJETIVO: estudar as mudancas na qualidade de vida relacionada a saude do inicio da anticoagulacao oral ao final de seis meses dessa terapia, e estudar as associacoes das caracteristicas sociodemograficas e clinicas com as medidas de qualidade de vida e estado de saude geral seis meses apos o inicio do tratamento, em individuos com diversas indicacoes clinicas para anticoagulacao oral. METODO: estudo prospectivo realizado em um municipio do Parana, Brasil, avaliando 78 pacientes. Foram utilizados os instrumentos Duke Anticoagulation Satisfaction Scale e Medical Outcomes Survey Short Form SF-36. RESULTADOS: a idade media foi 57 anos (D.P.= 16) e 54% eram mulheres. Comparado com o inicio da terapia, houve melhora estatisticamente significante na qualidade de vida relacionada a saude aos seis meses de seguimento. Os modelos de regressao linear explicaram 32% e 30%, respectivamente, da variância do Duke Anticoagulation Satisfaction Scale e do estado geral de saude. Houve melhora em todos os componentes do SF-36, exceto Saude Mental. CONCLUSAO: O uso do anticoagulante oral foi associado a melhora da qualidade de vida relacionada a saude nos seis meses de acompanhamento. Por ser longitudinal, esse estudo tem menos limitacoes que os estudos transversais publicados na area da Enfermagem brasileira ate o momento.OBJECTIVE to study the changes in health-related quality of life from beginning of anticoagulation therapy to six-month follow-up, and to study associations of sociodemographic and clinical characteristics with measures of quality of life and general health status at six-month follow-up, in individuals using oral anticoagulation due to various medical indications for the therapy. METHOD prospective study performed at a city in the state of Paraná, Brazil, composed of 78 patients. Measures included the Duke Anticoagulation Satisfaction Scale and the Medical Outcomes Survey Short Form SF-36. RESULTS mean age was 57 years (S.D.= 16) and 54% were women. Compared to the beginning of therapy, there was a statistically significant improvement in health-related quality of life at six-month follow-up. Linear regression analyses explained 32% and 30%, respectively, of the variance of the Duke Anticoagulation Satisfaction Scale and of the general health status. There was improvement in all components of the SF-36, except Mental Health. CONCLUSION The use of oral anticoagulation therapy was associated with improvement in health-related quality of life in the first six months of therapy. This study is longitudinal and therefore, has fewer limitations than cross-sectional studies published to date in the Nursing literature in Brazil.